title: Bluebottle envenomation-induced crystalline keratopathy.
abstract: OBJECTIVE
  To report a patient who developed a crystalline keratopathy after bluebottle envenomation of the cornea.
  
  
  METHODS
  Case report with histopathological correlation and literature review.
  
  
  RESULTS
  A 61-year-old man presented to the Ophthalmology clinic after he was stung in the left eye by a bluebottle while swimming in the sea. He complained of ocular and facial pain, facial swelling, and transient blurred vision. First aid by the beach included a hot shower and methoxyflurane for the pain. Crystalline deposits and pseudodendritiform epithelial defects were noted on slit-lamp examination. Topical chloramphenicol was prescribed, and 2 days after the injury, the cornea was debrided of persisting crystalline material. The cornea healed quickly after debridement with visual acuity improving from 6/9 to 6/6 in the affected eye. Microscopic examination demonstrated the corneal crystals to be irregularly shaped and nonrefractile with squared off edges. Raman spectroscopy partially identified the crystals as calcium based.
  
  
  CONCLUSIONS
  Although bluebottle stings of the cornea are infrequent, they may be challenging to manage. In addition to inactivation of the nematocysts and pain management, early debridement of the foreign matter may aid in the rapid resolution of the symptoms.
authors.affiliation: Department of Pathology, School of Medical Sciences, University of New South Wales, Sydney, Australia.
authors.forename: Jeanie J
authors.initials: JJ
authors.lastname: Chui
authors.forename: Kenneth G-J
authors.initials: KG
authors.lastname: Ooi
authors.forename: Dianne
authors.initials: D
authors.lastname: Reeves
authors.forename: Ian C
authors.initials: IC
authors.lastname: Francis
mesh_terms: D000818:Animals; D001733:Bites and Stings / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D002118:Calcium; D002701:Chloramphenicol / Q000627:therapeutic use; D003064:Cnidarian Venoms / Q000009:adverse effects*; D003131:Combined Modality Therapy; D003316:Corneal Diseases / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D003646:Debridement; D058447:Eye Pain / Q000209:etiology; D006801:Humans; D037402:Hydrozoa; D002479:Inclusion Bodies / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D014792:Visual Acuity
chemical_list: D003064:Cnidarian Venoms; D002701:Chloramphenicol; C029735:physalitoxin; D002118:Calcium